Analysis of Alternatives for Combined and/or Collaborative Syndromic Surveillance Within DoD and VA

The Joint Incentive Fund (JIF) Authorization creates innovative DoD/VA sharing initiatives. In 2009, DoD and VA commenced a biosurveillance JIF project whose principle objectives include improved situational awareness of combined VA/ DoD populations 1 and determining the optimal business model allowing both agency biosurveillance programs to operate more efficiently by: 1) consolidating information technology assets; 2) targeting enhanced collaboration for improved public health outcomes; and 3) improving buying power, and return on investment.

August 23, 2017

New Master Mapping Reference Table (MMRT) to Assist ICD-10 Transition for Syndromic Surveillance

As of October 1, 2015, all HIPAA covered entities transition from the use of International Classification of Diseases version 9 (ICD-9-CM) to version 10 (ICD-10-CM/PCS). Many Public Health surveillance entities receive, interpret, analyze, and report ICD-9 encoded data, which will all be significantly impacted by the transition. Public health agencies will need to modify existing database structures, extraction rules, and messaging guides, as well as revise established syndromic surveillance definitions and underlying analytic and business rules to accommodate this transition.

September 01, 2017

Preliminary Look into the ICD9/10 Transition Impact on Public Health Surveillance

On October 1, 2015, the number of ICD codes will expand from 14,000 in version 9 to 68,000 in version 10. The new code set will increase the specificity of reporting, allowing more information to be conveyed in a single code. It is anticipated that the conversion will have a significant impact on public health surveillance by enhancing the capture of reportable diseases, injuries, and conditions of public health importance that have traditionally been the target of syndromic surveillance monitoring.

September 07, 2017

Use of Electronic Health Records to Determine the Impact of Ebola Screening

Since the largest epidemic of Zaire ebolavirus (EBOV) in recorded history began in Guinea in December 2013, the epidemic has spread to neighboring countries of Liberia and Sierra Leone resulting in an estimation of over 27,000 total cases and over 11,000 deaths to date. In response to the widespread social disruption caused by this epidemic in West Africa, President Obama committed approximately 2,000 US service members to deploy to the region and provide humanitarian aid.

September 20, 2017

Evaluation of Praedico™, A Next Generation Big Data Biosurveillance Application

The National Strategy for Biosurveillance promotes a national effort to improve early detection and enable ongoing situational awareness of all-hazards threats. Implicit in the Strategy’s implementation plan is the need to upgrade capabilities and integrate multiple disparate data sources, including more complete electronic health record (EHR) data into future biosurveillance capabilities. Thus, new biosurveillance applications are clearly needed.

November 01, 2017

Preparing for the Impact of the ICD-9/10 Transition on Syndromic Surveillance

The US Department of Health and Human Services has mandated that after October 1, 2015, all HIPAA covered entities must transition from using International Classification of Diseases version 9 (ICD- 9) codes to using version 10 (ICD-10) codes ( This will impact public health surveillance entities that receive, analyze, and report ICD-9 encoded data.

November 17, 2017

Automated Real-Time Surveillance Using Health Indicator Data Received at Different Time Intervals

The Johns Hopkins Applied Physics Laboratory and the Armed Forces Health Surveillance Center have developed a hybrid processing engine that alerts monitors when a severe health condition exists based on corroboration among several sources of data. The system was designed to ingest a day's worth of recent data and provide results to monitors daily. In some theaters, the health of the US Forces must be determined at near-real time rates requiring a reassessment of current surveillance practices.

August 22, 2018

Best Practices for Implementing Electronic Disease Surveillance Systems in Resources-constrained Settings

Developing countries bear the highest burden of infectious diseases, and therefore play a key role in the detection of emerging disease threats. The ability of these countries to detect such events allows an adequate response preventing its spread and reducing the morbidity and mortality of communities across the world. Due to the importance of strengthening the surveillance capabilities of developing countries, resources need to be dedicated to this effort. International organizations often provide technical and financial support when countries need assistance.

August 22, 2018

Coverage and Timeliness of Combined Military and Veteran Surveillance Systems

An objective of the Joint VA/DoD BioSurveillance System for Emerging Biological Threats project is to improve situational awareness of the health of combined VA and DoD populations. DoD and VA both use versions of the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE). With a retrospective outpatient data collection available, we analyzed relative coverage and timeliness of the two systems to understand potential benefits of a joint system.


January 12, 2018

Localized Cluster Detection Applied to Joint and Separate Military and Veteran Subpopulations

The Joint VA/DoD BioSurveillance System for Emerging Biological Threats project seeks to improve situational awareness of the health of VA/DoD populations by combining their respective data. Each system uses a version of the Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE); a combined version is being tested. The current effort investigated combining the datasets for disease cluster detection. We compared results of retrospective cluster detection studies using both separate and joined data.

May 17, 2018


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